After School Info Payment Update

After School Programs Info Payment Update
Enrolled Student Information

First NameLast Name
Grade Level
Email
example@example.com
I authorize Ocean Charter School to charge my card on file. I understand that no refunds/credits are given.
Payment Information

A valid credit card number MUST be submitted. If upon enrollment the card on file fails the student will be removed and you will need to re-apply.
First Name* Last Name* Street Address* City* State* Postal/Zip Code*
Credit Card #* Exp Date* CVV*
Signature
Date

MonthDayYear
2 digit month, 2 digit day, 4 digit yearToday's Date
Should be Empty:

After School Programs Info Payment Update